Ryan, Edward T. PROJECT SUMMARY/ABSTRACT International travel may not only increase the risk of infection for an individual traveler, but may also contribute to the global spread of infections. Despite this, there are limited recent health-related data concerning individuals traveling internationally from the United States. There are limited health-related data on destination, duration, seasonality, and type of travel; there are also limited data on the role, efficacy, and attitudes regarding preventative strategies, including immunization, education, and chemoprophylaxis. We hypothesize that research focusing on promotion of the health of international travelers could improve our understanding of health interventions for this important global sub-population, could promote the health of individual international travelers (and thus may subsequently diminish the likelihood of spread of infections within new communities), and may lead to improved interventions. To focus this research, we propose to form a national travel clinic research consortium (Global TravEpiNet: Global Travelers'Epidemiology Network-Travelers'Health National Research Center Consortium) comprised of travel clinics geographically spread across the United States. For this project, this consortium would focus on three specific aims. #1: To assess current clinical practices regarding preventative strategies for international travelers, and to estimate national vaccine coverage rates (and other preventative strategies) using these data. #2: To assess knowledge, attitudes, and practices of travel health providers, focusing on knowledge, attitudes, and practices regarding special category or high-risk international travelers, including the elderly, the immunosuppressed, individuals visiting friends and relatives overseas (VRFs), and travelers to areas of the world at high risk for malaria, yellow fever, dengue or other communicable diseases. #3: To assess the attitudes and beliefs of international travelers regarding preventative health strategies. For this last specific aim, we would focus our efforts on two populations of international travelers: the first would be among travelers presenting to a consortium site prior to international travel;the second would be among international travelers who did not made contact with the healthcare system prior to high-risk international travel. For this latter sub-aim, we would work in collaboration with officials at Logan International Airport, Boston, Massachusetts. Identification of major impediments to interactions with the healthcare system prior to high-risk international travel could lead to improved interventions that would increase the use and effectiveness of preventative strategies among this population.